CULTURAL VALUES, PARENTING, AND HELP-SEEKING BEHAVIORS: CHINESE AMERICAN WELL-BEING IN EMERGING ADULTHOOD
A Dissertation by
MICHELLE MARIE SOOHOO
Submitted to the Office of Graduate and Professional Studies of Texas A&M University
in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY
Chair of Committee, Jeffrey Liew Co-Chair of Committee, Nathan H. Clemens Committee Members, Robert W. Heffer, Jr.
Oi-Man Kwok William A. Rae Head of Department, Shanna Hagan-Burke
August 2018
Major Subject: School Psychology
ABSTRACT
As the median age of second-generation Asian Americans continues to grow past the age of maturity, it becomes increasingly important to better understand the mental health needs of Chinese American emerging adults. The present study explored the influence of parental
practices, cultural values, and parent-child conflict as they relate to Chinese American emerging adults’ help-seeking behaviors and well-being. A community sample of Chinese American adolescents were recruited to complete batteries of questionnaires regarding parenting styles, cultural values adherence, parent-child conflict, help-seeking intentions, attitudes, and behaviors, and well-being outcomes on two separate occasions separated by approximately six years. Correlational analyses were conducted to test hypothesized relationships and models.
Results from this study did not show a link between parent-child conflict and seeking intentions and behaviors; however, analyses identified a positive relation between help-seeking intentions and behaviors and well-being outcomes in Chinese American emerging adults. Analyses determined participants engaged in informal help-seeking behaviors more frequently than formal help-seeking behaviors. Additionally, those who engaged in any type of help-seeking behavior reported higher levels of well-being, as indicated by lower levels of internalizing
problems and increased satisfaction with life, than those who did not engage in any form of help-seeking. Therefore, results suggest that there is a direct link between Chinese American
ACKNOWLEDGMENTS
I am thankful for the unwavering support from my committee who have each uniquely encouraged and guided me through my graduate school journey. A special thank you to Dr. Jeffrey Liew for encouraging me to explore a topic that is near and dear to my experiences growing up as a second-generation Chinese American. Your encouragement, expertise, and dedication to my growth as a scholar made the completion of this study possible. I also wish to thank my co-chair, Dr. Nathan Clemens, who was instrumental in developing my appreciation for research. Thank you for allowing me opportunities to learn that well-done research leads to real world changes. I am also extremely thankful for the support of Drs. Robert Heffer, Oi-Man Kwok, and William Rae. You have each selflessly shared your knowledge and expertise
throughout my graduate school journey, and I know I have emerged as a better scholar and clinician because I’ve had each of you as a teacher and mentor.
I wish to acknowledge each member of the Project CASL research team. This dissertation would have been possible without your commitment and belief that this little-researched topic area deserved continued exploration. To classmates who have become family, thank you for showing me the that there is even more to learn outside of the classroom.
I also want to thank my family, especially my parents, for their constant love and support. I wouldn’t have had the courage to pursue my dreams without your never-ending
encouragement. Thank you for understanding this significant period of my life and for supporting me on a journey that was so foreign to you. Finally, thank you, Willis, for your strength, patience, and unwavering support. I couldn’t have done this without you.
CONTRIBUTORS AND FUNDING SOURCES
This work was supported by a dissertation committee consisting of Jeffrey Liew, Ph.D., Chair of Dissertation Committee, Nathan Clemens, Ph.D., Co-Chair of Dissertation Committee, Oi-Man Kwok, Ph.D., and William Rae, Ph.D. of the Department of Educational Psychology and Robert Heffer, Ph.D. of the Department of Psychological & Brain Sciences.
The data analyzed for Chapters III and IV were provided by Jeffrey Liew, Ph.D. of the Department of Educational Psychology, with financial contribution from the Hogg Foundation for Mental Health which made the original phase of Project CASL possible.
TABLE OF CONTENTS
Page
ABSTRACT ... ii
ACKNOWLEDGMENTS ...iii
CONTRIBUTORS AND FUNDING SOURCES ... iv
TABLE OF CONTENTS ... v
LIST OF FIGURES ... vii
LIST OF TABLES ... viii
CHAPTER I INTRODUCTION ... 1
CHAPTER II LITERATURE REVIEW... 4
Chinese American Parenting Through a Cultural Lens ... 4
The evolution of research related to Chinese parenting ... 4
Chinese parenting and psychological control ... 6
Considerations of culture in parenting ... 7
The Interplay Between Parenting and Culture in Parent-Child Conflict ... 10
Parent-child relationship research in the United States... 10
Parent-child conflict research in Asian American families ... 12
Current Understandings Regarding Help-Seeking Behaviors ... 13
The Impact of Parenting and Culture on Help-Seeking Behaviors ... 15
Well-Being and Psychosocial Adjustment in Chinese Americans ... 16
CHAPTER III THE PRESENT STUDY ... 21
Study Purpose and Hypotheses ... 21
Method ... 22
Participant sample and recruitment ... 22
Participants ... 22
Procedure ... 23
Utilization of Project CASL data. ... 23
Data collection and utilization of Project CASL 3.0 data. ... 23
Measures ... 24
Demographic questionnaire ... 24
Adolescent-reported parent psychological control ... 24
Emerging adult-reported help-seeking intentions ... 25
Emerging adult-reported frequency of help-seeking behaviors ... 26
Emerging adult-reported attitudes toward help-seeking behaviors ... 26
Emerging adult-reported perception of social support ... 27
Emerging adult-reported internalizing problems ... 27
Emerging-adult reported depressive and anxious symptoms ... 27
Emerging adult-reported satisfaction with life ... 28
Data analyses ... 29
CHAPTER IV RESULTS ... 33
Preliminary Analyses ... 33
Correlational Analyses... 35
Parental psychological control, adolescent adherence to Asian values, and parent-child conflict ... 35
Parent-child conflict and help-seeking intentions ... 35
Parent-child conflict and help-seeking behaviors ... 36
Help-seeking behaviors and well-being ... 36
Path Analyses ... 37
CHAPTER V CONCLUSIONS AND DISCUSSION ... 42
The Relations Amongst Cultural Values, Parental Psychological Control, Parent-Child Conflict, and Help-Seeking ... 42
Understanding Help-Seeking Within Parent-Child Conflict ... 43
Help-Seeking Intentions and Behavior’s Impact on Well-Being Outcomes ... 45
Limitations and Future Directions ... 47
LIST OF FIGURES
Page Figure 1: Hypothesized path model testing for mediation from culture and parenting to
well-being outcomes ... 30 Figure 2: Hypothesized path model testing for moderation from culture and parenting to
help-seeking behaviors and well-being outcomes ... 31 Figure 3: Hypothesized path model for moderation from culture and parenting to help-
LIST OF TABLES
Page
Table 1: Demographic characteristics of participants ... 33
Table 2: Descriptive data for study variables ... 34
Table 3: Bivariate correlations between study variables ... 38
Table 4: Bivariate correlations between parent-child conflict and help-seeking intentions ... 39
Table 5: Descriptive data for help-seeking frequency variables ... 40
CHAPTER I INTRODUCTION
The Asian American population grew faster than any other ethnic minority group
between 2000 and 2010 in the United States (U.S. Census Bureau, 2012). In fact, Asians recently surpassed Hispanics as the largest group of immigrants to the United States and, amongst this group, individuals of ethnic Chinese background comprise 23%, and the largest proportion, of Asian Americans in the United States (Pew Research Center, 2013).
As the population of Asian Americans and Chinese Americans continues to grow, it becomes essential to examine their mental health needs, as such research provides important data for future public health and policy decisions and direction for social research in the United States (Nguyen, 2011). The Chinese American population is still majority immigrant, with 74% of Chinese American adults having been born abroad. The median age amongst second-generation Asians is 17-years-old (Pew Research Center, 2013). Therefore, as second-generation Asians reared by hard-working, immigrant parents age into adulthood, with similar goals of achieving academic and economic success, it becomes important to examine factors that both encourage and endorse barriers to their success.
With the popularity of books, such as the Battle Hymn of the Tiger Mother (Chua, 2011), the unique aspects of Chinese parenting are gaining widespread attention and interest (Juang, Qin, & Park, 2013). Additionally, with the immigrant background of the majority of Chinese Americans who currently live in the United States, it appears that factors of acculturation and enculturation may be at play as parents and their offspring navigate what it means to be Chinese in the United States (Cheah, Leung, & Zhou, 2013). Studies have shown that while Chinese
American students demonstrate fewer externalizing disorders (Lau et al., 2004; Qin, Han, & Chang, 2011) and better academic outcomes (Kao, 1995; Kao & Thompson, 2003), relatively fewer studies have sought to look at their internalizing behaviors and well-being outcomes (Leong, Oka, & Lannert, 2011; Szymanski & Sung, 2010). In particular, studies on the prevalence of internalizing disorders in Asian Americans have been limited with a failure to disaggregate data for subgroups (Leong, Oka, & Lannert, 2011). In terms of their help-seeking behaviors, Leong and Lau (2001) found that Asian Americans seek help for their problems at a much lower rate than members of other groups.
There is currently a body of research that explores mental health utilization and help seeking behaviors in Chinese American adults. This body of research suggests an
underutilization of mental health services, with actual help-seeking behaviors related to more proximal need, or poorer mental health status (Ying & Miller, 1992). However, even in the presence of more proximal mental health care need, a suicide cluster in Palo Alto, CA that claimed four adolescent lives during the 2014-2015 academic year, three of whom were Asian American males (Rosin, 2006), suggests that chronic underutilization of mental health services exists across the lifespan within the Chinese American community.
Furthermore, Abe-Kim, Takeuchi, and Hwang (2002) determined that levels of family support and conflict were the strongest variables in determining help-seeking behaviors for medical, mental health, and informal services. In particular, Abe-Kim et al. (2002) determined that, while family conflict predicted both mental health and medical service use, strong family support was not related to help-seeking behaviors. However, neither Yang and Miller (1992) nor Abe-Kim et al. (2002) addressed the relation between help-seeking behaviors to individuals’ well-being outcomes. Currently, there have been no studies that have explored the influence of
help-seeking behaviors and intentions on well-being outcomes in Chinese American emerging adults as a standalone group.
In particular, this study will explore whether or not parental practices and cultural
orientation and values are related to Chinese American emerging adults’ help-seeking behaviors. Additionally, it remains to be determined whether or not formal and informal help-seeking behaviors are related to adult well-being outcomes in similar or different ways. Therefore, unique contributions of this dissertation study to the research literature will include examination of the familial and cultural factors, as well as help-seeking intentions and behaviors, that are associated with well-being outcomes for Chinese Americans.
CHAPTER II LITERATURE REVIEW
Chinese American Parenting Through a Cultural Lens
The evolution of research related to Chinese parenting. Parenting styles and methods have garnered much interest and research across the years. Baumrind (1971) utilized the
observational data from white preschool students to identify three unique parenting styles, hallmarked by parental responsiveness: authoritative, authoritarian, and permissive. Specifically, Baumrind (1971) indicated that parenting marked by parental demands for obedience, earmarked by punitive, forceful measures to minimize a child’s self-will is considered authoritarian
parenting while parenting that is marked by parental direction of activities in a rational, and issue-oriented method is considered authoritative parenting. Maccoby and Martin (1983) then introduced a second dimension to parenting style: parental demandingness. This led way to a fourth parenting style, identified by low demandingness and low responsiveness: neglectful. Research on parenting styles has expanded since its initial introduction by Baumrind (1971) and has often identified Chinese parenting as signified by an authoritarian (high demandingness, low responsiveness) style (Liew, Kwok, Chang, Chang, & Yeh, 2014). Authoritarian parenting has been associated with poor school performance in
European-American students, but better school performance in Asian students (Dornbusch et al. 1987). In a follow-up study, Steinberg et al. (1992) determined that the understanding of parenting styles as presented by Baumrind (1971) is irrelevant to those of Asian descent. In particular, Steinberg et al. (1992) determined that peer influence may be more effective in predicting school success in Asian American students. Examining the idea that parenting styles are irrelevant for Asian
parenting further, Darling and Steinberg (1993) identify a distinction between parenting practices and parenting style, noting that parenting style should be conceptualized as a method for
moderating the influence of parenting practices and culture on child socialization. One example of this was found in Leung, Lau, and Lam’s (1998) study, such that an authoritarian, rather than authoritative, parenting style was related to the academic achievement of Chinese students, but the opposite was found true of European American and Australian students.
Therefore, there are limitations to evaluating Chinese parenting under the strictly dimensional methods of Baumrind (1971). Classification of Chinese parenting as authoritarian has been considered ethnocentric and misleading, insufficient for incorporating eastern
ideologies, including Confucianism and collectivistic values (Chao, 1994). Additionally, Kim and Wong (2002) report that there is a need for culture specific and indigenous parenting
concepts in Asian American parenting, such as examining the concepts of filial piety and proper behavior.
One system of parenting style that has been identified as more appropriate for Chinese parenting, particularly when explaining the paradoxical success of Chinese students in the classroom, is the utilization of the concepts of “jiào xun” and “guǎn,” or training and to care for (Chao, 1994). Specifically, the concept of jiào xun represents demandingness for excellence, while guǎn represents parental safeguarding (see Liew et al., 2014). When taking into
consideration Baumrind’s (1971) findings, both concepts together represent Chinese parenting in a way that more similarly represents authoritative parenting, with high demandingness and high responsiveness (Liew, et al., 2014). On the other hand, Xu et al. (2005) determined in a sample of parents from mainland China determined that parents who reported both authoritative and authoritarian parenting styles also demonstrated behaviors that were highly correlated with
Chinese values, such as collectivism, emotional self-control, family recognition, filial piety, and humility.
Chinese parenting and psychological control. Taking into consideration the history of research on Chinese parenting, aspects of control over their children has also received
tremendous attention. In recent years, the concept of the “tiger” parent has gained attention in popular culture and media (e.g., Chua, 2011) and was made its way into child development and parenting research literature with a special section in the Journal of Asian American Psychology (e.g., Juang, Qin, & Park, 2013; Kim et al., 2013). “Tiger parenting” has been proposed as a possible explanation for the superior academic outcomes of Chinese or Asian students. However, the definitions of tiger parenting vary. One definition of tiger parenting identifies them as those who are very controlling, demonstrating authoritarian behaviors that propel their children to high levels of success (Chua, 2011). Another focuses on parenting that is marked by culture-based conflicts, shaming or disapproval, and parental monitoring (Supple & Cavanaugh, 2013). Both of these definitions highlight a level of control parents have over their children, and while tiger parenting provides a mechanism to explain the academic achievement of Chinese American students, it does not provide understanding for the well-being outcome of these individuals.
Barber (1996) defines the construct of parental psychological control as a method of parental discipline that appeals to an individual’s guilt and pride, expresses disappointment, isolates, utilizes shaming, and withdraws love. Therefore, it is a negative form of parenting that addresses many of the factors involved in tiger parenting. Research suggests that parental psychological control predicted poorer emotional functioning in seventh grade students in both China and the United States (Wang, Pomerantz, & Chen, 2007). Additionally, Pomerantz and Wang (2009) found that, in the presence of parental psychological control, children’s
psychological functioning is similarly negative in the United States and China. Further research has also shown that the relation between parental psychological control and adolescent
psychological well-being was poorer across two time points when both parents demonstrate high levels of psychological control at Time 1 (Shek, 2007). What is not immediately apparent is the impact this form of parenting can have on an individual’s psychosocial adjustment, particularly in the emerging adulthood stage of life.
Taken together, the literature regarding Asian-heritage, and in particular, Chinese parenting, demonstrates an evolving perspective that focuses largely on the academic achievements of Chinese Americans. As this field of research moves forward, it may be important to consider mental health outcomes in emerging adulthood as the median age of second-generation Asian Americans continue to grow past the age of maturity.
Considerations of culture in parenting. In addition to considering parenting styles, the cultural context in which parents and their children interact are also important to consider when exploring well-being outcomes in emerging adults. In particular, when considering Chinese parenting and the fact that native-born Asian Americans only comprise of 25.9% of the total U.S. Asian population (Pew Research Center, 2013), it is important to consider the enculturation and acculturation status of both parents and their children as an important and unique aspect to understanding their interactions and well-being outcomes.
Acculturation is the process by which a person is introduced to a new cultural environment and begins to gain traits from the new culture (Chen, Unger, Cruz, & Johnson, 1999). The U.S. has long embraced the idea of acculturation, identifying itself as a “melting pot” of cultures, such that all the different cultural, ethnic, and religious groups in the United States share common attitudes, values, and lifestyles (Bisin & Verdier, 2000); however the benefits of
acculturation may be better related to social context, such that neighborhood cultural
participation led to more positive self-esteem, depending on the cultural context individuals lived in (Schnittker, 2002). This notion can be related to Bronfenbrenner’s (1979, 1986, 1989)
ecological systems theory, which further supports the idea of multiple social contexts that interact with and contribute to the development of an individual. In particular, Bronfenbrenner’s ecological systems model describes the multiple “layers” of environment an individual is
embedded in, with those layers closest to the individual imparting the most influence on their development. Juang et al. (2007) further explores Bronfenbrenner’s (1979, 1986, 1989) ecological systems theory in such a way that suggests culture to be central and radiating out to affect all the microsystems, including the individual and their family. Therefore, when parents and adolescents experience a mismatch of their cultural values, attitudes, and beliefs, the parent-child conflict that may develop can lead to a variety of issues for Asian-American adolescents and emerging adults (Juang et al., 2007).
Crane, Ngai, Larson, and Hafen (2005) determined that as the acculturation gap, or the difference between parents’ and adolescents’ acculturation levels, increased, the more likely the adolescent is to experience depression and delinquency, over and above general family
functioning. This being said, it can be inferred that differences in acculturation between
adolescents and their parents are a stronger predictor for depression than family functioning. On a similar note, Sung (2010) determined that cultural beliefs and values impact both interaction and parenting practices that affect the parent-child relationships. Those adolescents who reported lower emotional intelligence, which is related to skills in adaptability, interpersonal relationships, resiliency, self-awareness, and stress management tended to have parents who reported more
hierarchical and domineering belief systems, which are more associated with an authoritarian type of parenting.
Furthermore, in a study examining intergenerational conflict in Chinese American families, Lim et al. (2008) utilized hierarchical multiple regression analyses to find partial support for a relation between youth distress and acculturation gaps between parent and child. Additional examination determined that intergenerational conflict and parenting style were associated with adolescent distress over and above the effects of acculturation gaps.
Interestingly, Lim et al. (2008) determined that higher depression and somatization was associated with acculturation gaps identified by a less acculturated adolescent and more acculturated parent, suggesting that directionality of acculturation gaps is also an important factor to consider.
In addition to examining interactions between parents and their offspring, examination of the needs of individuals may also be important to consider. Under Self-Determination Theory (SDT), the satisfaction of needs for autonomy, competence, and relatedness is a requirement for psychological well-being and to achieve to an individual’s fullest potential (Deci & Ryan, 1985; Ryan & Deci, 2000). Church et al. (2013) carried this theory further, in an examination across college students in eight countries and determined that those from Asian cultures had both lower scores on needs associated with Self-Determination Theory and lower eudaimonic well-being. Therefore, the authors determined that a perceived imbalance in the satisfaction of needs predicted well-being outcomes, especially in relation to negative affect.
Autonomy, as represented by SDT, represents volitional functioning in that individuals are able to experience themselves as behaving according to their own well-internalized values and interests (Ryan, Deci, & Grolnick, 1995), which leads to the idea that parenting that
promotes volitional functioning leads to better well-being outcomes (Grolnick, 2003). Soens et al. (2007) determined that parental promotion of volitional functioning promoted positive adolescent psychosocial and well-being outcomes over and above reports of parental promotion of independence. In a study about autonomy amongst Chinese learners, Vansteenkiste, Zhou, Lens, and Soenens (2005) determined that in addition to being advantageous for academic achievement, parental promotion of volitional functioning promoted positive adjustment and well-being outcomes in Chinese students.
The Interplay Between Parenting and Culture in Parent-Child Conflict
Parent-child relationship research in the United States. Parent-child relationships are a common topic of discussion when trying to understand development, though much research on the topic has often been completed with European American dyads (Phinney, Kim-Jo, Osorio, & Vilhjalmsdottir, 2005). One important component to consider when exploring parent-child relationships is understanding the influence of previous patterns of interaction on current and future patterns of interaction (Aquilino, 1997). Aquilino (1997), using data from the National Survey of Families and Households at two time points, determined that learned patterns of interaction, such as those exhibited in adolescence, will continue to influence the way in which a parent interacts with their children as adults; however, the transition in which a child leaves home appears to have the greatest power in altering earlier styles of parenting, such that reducing the intensity of a parent’s relationship with their child. The participants in this study identified as white and black, so it remains to be seen whether or not this relation holds with Chinese
American emerging adults.
Koepke and Denissen (2012) utilized the notion of separation-individuation to explore parent-child interactions during major transitions: from childhood to adolescence to emerging
adulthood. Under this theory, separation reflects the dissolution of the “symbiotic fusion between child and mother,” while individuation reflects the child’s “awareness of his or her own
individual characteristics.” Specifically, Koepke and Dennisen (2012) suggests that parent-child relationships can be viewed as the negotiation of needs and future research should be directed toward exploring parent-child interactions at the important transitions between adolescence and emerging adulthood.
Other findings have also indicated that amongst European American adolescents, parental promotion of autonomy and independence was positively related to measures of ego
development and self-esteem (Allen, Hauser, Bell, & O’Connor, 1994). On the other hand, Rothbaum et al. (2000) determined that there are major differences in adolescent development when comparing youth in the United States and Japan. It was determined that adolescents in the United States tended to individuate from their parents and develop closer bonds to their peers while those in Japan focused on continuity and stability of the relationship throughout
adolescence.
Other research has also determined that European American families emphasize independence and autonomy in adolescence while ethnic minority families emphasize
interdependence and obedience and respect for elders (Fuligni, Tseng, & Lam, 1999; Phinney, Ong, & Madden, 2000). Taken together, it can be presumed that family relationships differ amongst different cultural and ethnic groups in the United States and that culture plays a large part in an individual’s parenting methods (Phinney et al., 2005).
This field of research lends itself readily to explorations of how parenting expectations and level of acculturation may impact parent-child relationships, particularly as it relates to
well-being outcomes and as children of immigrants adopt the values and behaviors of the host culture at a quicker pace than their parents (Qin et al., 2011).
Parent-child conflict research in Asian American families. As an individual works through the expectations of the many different ecological contexts they interact with on a daily basis, it can be inferred that acculturative gaps between parent and child can lead to familial conflict. For example, while Kim and Choi (1994) found that while Korean American immigrants will adopt some of the traditionally Western values, such as independence, Kim, Atkinson, and Yang (1999) determined that they retain traditional Asian values over and above what is seen in European Americans. Additionally, Lee, Su, and Yoshida (2005) determined that parent-child intergenerational conflict was the most frequent issue amongst Asian American young adults who sought counseling. Supporting this in a Cambodian and Vietnamese sample, Choi, He, and Harachi (2008) argued that when a young adult perceives dissonance in cultural values with their parents, they report higher rates of parent-child conflict and demonstrate a larger increase in problem behaviors.
In a Chinese sample from Canada, Costigan and Dokis (2006) determined that parent and child orientation to Chinese culture, rather than Canadian culture, served as the most consistent predictor for child adjustment outcomes such that when mothers reported relatively high levels of Chinese behaviors and their child reported relatively low levels of Chinese behaviors, the child demonstrated poorer adjustment and academic success. Additionally, the literature suggests that, in consideration of paternal and maternal parenting differences, a large acculturation gap between fathers and their children is associated with parenting practices that are considered unsupportive and linked to poorer emotional outcomes in their children (Kim et al., 2009). Given the evidence that suggests parent-child conflict, particularly as it relates to parenting style and
culture, impacts well-being outcomes in a detrimental way, it then appears important for researchers to examine the methods in which a child copes with the conflict and whether or not the child will reach out for help. It also provides support for developing the most appropriate interventions for this growing group of individuals in the United States.
Current Understandings Regarding Help-Seeking Behaviors
Help-seeking often refers to the “behavior of actively seeking help from other people… in response to a problem or distressing experience” (Rickwood, Deane, Wilson, & Ciarrochi, 2005). Both help-seeking behaviors and intentions have been identified as important aspects to consider when creating interventions to support adolescent and emerging adult well-being; however, less about preferences for help-seeking, such as formal versus informal help-seeking behaviors have been explored (D’Avanzo et al., 2012). The following section attempts to delineate the efforts of the help-seeking literature thus far.
Help-seeking research has often looked at one’s intent to engage in such behavior. Ajzen (1985) argued that an individual’s intent to engage in any sort of behavior, if internal and
external forces to engage in the behavior have little to no influence on the completion of said behavior, one’s intention to perform the behavior remains the only determinant of the behavior. Specifically, if one is able to accurately measure the intention of a behavior, one should be able to accurately identify one’s behavior, barring any significant internal or external force of influence. Cramer (1999) went a step further by exploring the influence of four psychological antecedents (level of distress, attitudes toward professional psychological counseling, available social support, and self-concealment) on college-aged individuals’ help-seeking behavior. Using path models and a predominantly European American sample, it was determined that those who engaged in self-concealing behavior tended to have lower levels of social support and poorer
attitudes toward counseling. A secondary finding postulated that self-concealing behaviors were more related to higher levels of distress, while help-seeking intentions were more strongly related to positive attitudes toward counseling. Cramer (1999) suggests that those who engage in self-concealing behaviors are often caught in an “approach-avoidance conflict” in which they are skeptical about the benefits of counseling, causing them to avoid sharing their distress with others or seeking professional help.
Continuing this line of research, Liao, Rounds, and Klein (2005) explored the
generalizability of Cramer’s (1999) help-seeking model, with considerations of acculturation, in a sample of Asian and Asian American college students. It was determined that Cramer’s (1999) model is generalizable to Asian American college students; however, structural invariance analysis demonstrated that factors within the model are not identical between the predominantly European American and Asian American samples. This suggested that self-concealing behaviors were more highly associated with a negative attitude toward counseling in the Asian American group. It can be speculated that variables related to traditionally Asian values, such as shame and loss of face (Ho, 1991), may be related to self-concealing behaviors and lower usage of
professional mental health services. Similarly, Ting and Hwang (2009) determined that stigma tolerance predicted help-seeking attitudes above and beyond traditional variables, such as social support and conflict, associated with help-seeking in Asian American college students and Kim (2007) determined that enculturation to Asian cultural values were inversely related to attitudes toward seeking professional psychological help.
In terms of preference between formal and informal help-seeking behaviors, Chin et al. (2014) determined that, in a sample of adult patients in Hong Kong in a primary care setting, respondents preferred consulting with friends and family rather than with mental health
professionals, such as psychiatrists or psychologists, with lower intentions to seek help from any person or group with the presence of depression. Over the course of one year, the authors
determined that neither reporting greater intention to seek professional help nor reporting more severe depressive symptoms at baseline were associated with greater utilization of professional mental health services. Additionally, Leung, Cheung, and Tsui (2012) found that, among Chinese American adults with depressive symptoms, only 4.7% sought help from mental health professionals while 65.1% preferred to seek help from relatives and friends or showed no preference at all.
School mental health services are also areas in which students are able to access
professional mental health services. In a study on preferences for help-seeking for mental health problems in Italian students, D’Avanzo et al. (2012) found that Italian students of both genders had a high propensity for seeking help with mental health concerns, with the most preferred method for help-seeking through informal means (e.g., friends). This suggests that help-seeking behaviors, without distinction of formal or informal means, should be promoted. Informal help-seeking is especially important to consider given research with Asian American students suggest that they tend to underutilize school-based services (Anyon, Whitaker, Shields, & Franks, 2013). In particular, it was found that Chinese American adolescents did not recognize their own health or psychological concerns, partially due to stigma and cultural factors, and only sought school health services with teacher referral. Chinese American students also reported that the need for school health services were only for those who were having “personal problems” such as early sexual activity or drug use, rather than those who may be demonstrating mental health concerns.
The Impact of Parenting and Culture on Help-Seeking Behaviors
To date, there has been no research that has explored at the impact parenting and culture may have on an individual’s help-seeking behaviors, particularly as it relates to the area of well-being outcomes. In a study about the social influences related to children’s adaptive help-seeking in the school setting, Newman (2000) suggests that parenting choices as they relate to parent-child interactions in parent-childhood provide lessons, such as learning that difficulty and failure may require assistance and that they can count on adults and others for help, that are crucial for developing children’s adaptive help-seeking skills in the school setting. Therefore, it can be suggested that parent-child interactions and conflicts are important to examine when exploring help-seeking behaviors in emerging adulthood, a time when individuals are learning to navigate the word apart from their parents.
In terms of culture, Cauce et al. (2002) created a model for mental health help-seeking in adolescents from ethnically diverse backgrounds and determined that culture has a strong impact on one’s decision to seek treatment, especially when parents believe that their child should not dwell on their problems (Cheng, Leong, & Geist, 1993). It was also determined that
understanding the pathway in which individuals from ethnically diverse backgrounds seek help (e.g., problem identification, decision to seek help, and service selection) are important future steps to take to provide culturally competent mental health services to a growing, ethnically diverse, adolescent population in the United States (Cauce et al., 2002).
Well-Being and Psychosocial Adjustment in Chinese Americans
One might argue that examining help-seeking behaviors and intentions of Chinese Americans is only necessary if they are experiencing mental health concerns. One of the dominant stereotypes of Chinese American youth is that they represent the “model minority,”
such that they are self-sufficient and problem free (Anyon et al., 2012), making it appear as if they are a group that does not demonstrate any mental health needs. While the data is limited, it has been suggested that Asian American adolescents generally have higher rates of unmet mental health needs and are at greater risk for internalizing disorders, such as depression and anxiety and suicide (Leong & Lau, 2001). Two suicide clusters, or multiple suicide deaths in close succession and proximity, of which a majority of the victims in the second cluster were hard-working, well-liked Asian American males, since 2009 have rocked the Palo Alto, CA area (Rosin, 2015). Factors from parental pressure to succeed to low levels of sleep have been speculated as the reason behind the suicides. As a result, the Centers for Disease Control and Prevention (CDC), in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), completed an investigation on youth suicide in the Santa Clara County, CA area. One of the recommendations from the preliminary report of this investigation included encouraging help-seeking behaviors to improve mental health, focusing on youth from diverse backgrounds, particularly those of Asian descent (Centers for Disease Control and Prevention, 2016).
Research has demonstrated that factors related to parent-child conflict are associated with mental health outcomes, with the majority of the research looking at adolescent functioning. Shek (2002) found that Chinese adolescents who perceived parenting characteristics to be negative (as defined by harshness and demandingness) had higher levels of parent-adolescent conflict. In a different study, Shek (1999) found harsh and demanding parenting characteristics to be associated with low self-esteem, hopelessness, negative life satisfaction, and general psychiatric morbidity. In contrast, positive parenting characteristics such as demonstrating concern and responsiveness were associated with positive psychological well-being outcomes
(Shek, 1999). Additionally, Ang (2006) determined that adolescents “who come from homes perceived to be authoritative were more confident in their abilities, better adjusted socially and more competent.” Authoritarian parenting style appears to have a different meaning when interpreted by Asian participants. In the Singapore sample, Malay adolescents who perceived their mothers to be authoritarian also had better adjustment on attitude to school. These Malay adolescents were as adaptive and well-adjusted on attitude to school as were Malay adolescents who perceived their mothers as authoritative. This could possibly be because control, care, and concern are almost synonymous within the Asian culture. On the other hand, Yeo, Ang, Chong, and Huan (2007) determined that emotional well-being is a dominant concern for Singaporean youths, particularly in girls.
When taking into consideration the cultural and parenting factors indicated earlier, one may be interested in understanding how culture and parenting experiences impact an individual as they transition out of the household and into college or the work force. Few studies have explored the Chinese American emerging adult experience, particularly in the area of psychosocial adjustment and well-being. Relatively more focus has been given to the
psychosocial adjustment of Asian international students, though the literature is also lacking in this area. In particular, it has been found that there is a positive relation between acculturative stress and depression in Chinese international students (Wei et al., 2007). It was also determined that, after controlling for acculturative stress, maladaptive perfectionism was also positively related to depression (Wei et al., 2007).
There have also been relatively few studies that have explored the well-being outcomes in Asian Americans and whether or not true differences exists in Asian American well-being outcomes. Chang, Chang, and Chu (2006) conducted a review of the literature focusing on
personality that showed only six of 5,698 studies published between 1990 and 1999 focused on Asian Americans—less than 0.1%. A specific study that focused on ethnic differences between Asian Americans and European American college students’ rumination and adjustment found that ethnic variation existed in rumination (Chang, Tsai, & Sanna, 2010). In particular, Chang, Tsai, and Sanna (2010) found that Asian Americans have the tendency to ruminate more than European Americans; however, whether or not this tendency to ruminate led to poorer well-being outcomes was not clear.
In summary, based on the research literature reviewed, it appears that well-being outcomes in Chinese American emerging adults are impacted by numerous factors, such as parenting and cultural factors, as well as parent-child conflict and help-seeking behaviors. Negative parenting characteristics, such as harshness and demandingness (Shek, 2002), as well as young adult perceived cultural values dissonance (Choi, 2008), are suggested to lead to higher levels of parent-child conflict. Parent-child conflict has also been identified as the most frequent issue amongst Asian American young adults who sought counseling (Lee, 2005).
What is less clear in the literature is how help-seeking behaviors may impact well-being outcomes in Chinese American emerging adults, given their parenting, cultural, and parent-child conflict experiences. It has been documented that experiences related to parental psychological control (Wang et al., 2007), acculturative gaps and enculturation (Cauce, 2002; Kim, 2007), and parent-child conflict (Lee, 2005) can lead to adverse well-being outcomes, often manifesting in internalizing behaviors (Leong & Lau, 2001). Encouraging help-seeking is regularly a suggestion for assisting emerging adults who want to work though issues causing distress (Centers for Disease Control and Prevention, 2016); however, whether or not one engages in such behaviors,
or whether or not help-seeking is predictive of well-being outcomes in Chinese American emerging adults is currently unclear.
CHAPTER III THE PRESENT STUDY
Study Purpose and Hypotheses
The purpose of this study is to investigate cultural and parental factors during adolescence that are related to parent-child conflict, help-seeking intentions, attitudes, and behaviors, and well-being outcomes (e.g., internalizing problems and satisfaction with life) during emerging adulthood in Chinese Americans. In addition, the study is interested in
examining whether help-seeking intention and behaviors and reported well-being outcomes, as indicated by self-reported internalizing problems and life satisfaction, are predicted by parent-child conflict. See Figures 1, 2, and 3 for the hypothesized models to be tested.
This study will build upon previous literature and attempt to address the gaps in the literature by utilizing adolescent responses about psychological control and Asian values adherence, as well as follow-up with the adolescents, now emerging adults, to determine expression of parent-child conflict, help-seeking behaviors and intentions, and emotional well-being outcomes.
This study will seek to test the following hypotheses.
1. Lower adherence to Asian values and higher reported parental psychological control will predict higher reported levels of parent-child conflict.
2. Higher levels of parent-child conflict, in conjunction with lower reported adherence to Asian values and higher parental psychological control, will predict lower levels of help-seeking intentions.
3. Higher levels of parent-child conflict, in conjunction with lower reported adherence to Asian values and higher parental psychological control, will predict lower levels of formal help-seeking behaviors.
4. Lower levels of help-seeking behaviors will predict lower levels of well-being, indicated by higher levels of internalizing problems and lower life satisfaction.
Method
Participant sample and recruitment.
Participants. Participants were recruited from Chinese language schools, churches, cultural community centers, and through utilizing a snowball recruitment strategy that began in 2010 in a study called “Project CASL”. Inclusionary criteria stipulated that families must self-identify as of Chinese descent, be able to read and speak English, and have adolescent children between the ages of 14 and 18 years old. 106 immigrant families were recruited, resulting in 203 individual participants (consisting of parents and adolescents). Data on cultural and parenting factors were collected from participants during this phase of the study. The majority of parents who participated in the study were born and raised outside of the United States, while most adolescents who participated in the study were born and raised in the United States.
Adolescent participants of Project CASL, now emerging adults, were once again contacted in 2017 to participate in a study called “Project CASL 3.0.” Inclusionary criteria to participate in Project CASL 3.0 stipulated that all participants must have been adolescent children recruited during Project CASL. Participants must also be over the age of 18. Recruitment strategies for this phase of the study included contacting former participants by using telephone, email, and social media information provided to the researchers during prior phases Project CASL.
Procedure.
Utilization of Project CASL data. Data related to adolescent reported parenting and cultural values utilize data collected from 2010 to 2011 as a part of Project CASL. Specific measures used include demographic data and measures of adolescent-reported parental psychological control and adherence Asian values.
Data collection and utilization of Project CASL 3.0 data. Data related to parent-child conflict, help-seeking behaviors, and current well-being for emerging adult participants were collected during the Project CASL follow-up study, Project CASL 3.0. Participating emerging adults were contacted by email, social media, or telephone using an existing database of their contact information. During this phase of data collection researchers attempted to contact all eligible participants from Project CASL (109 adolescents). Of these attempts, researchers encountered 11 email addresses that were no longer active and 31 phone numbers that were disconnected. Voicemails were left for 19 participants, but these voicemails were left unreturned. A total of 62 participants were successfully contacted during Project CASL 3.0 recruitment efforts. After participants who were contacted provided informal written or verbal consent, participants were emailed a unique URL to access the online surveys. After completing online informed consent, participants were directed to online surveys. After completion of the surveys, participants were provided with a $25 gift card to thank them for their participation in the follow-up study. Of the 109 original adolescent participants, 60 participants expressed interest and agreed, while two participants verbally declined, to participate in Project CASL 3.0.
Participants of Project CASL 3.0 were 40% male (60% percent female). Participants ranged in age from 19 to 26 with 1.70% who were 19 years old, 11.70% who were 20 years old, 21.70% who were 21 years old, 25% who were 22 years old, 16.70% who were 23 years old,
15% percent who were 24 years old, 5% who were 25 years old, and 3.30% who were 26 years old. The majority of young adults in this sample were born in the United States (81.7%) while the majority of their parents were born in China or Taiwan (88.30%). Therefore, the majority of the young adults represented in this sample are second-generation Chinese Americans.
Additionally, an error during data collection resulted in the completion of the Asian American Family Conflicts Scale, a measure of parent-child conflict, by 49 of the 60 Project CASL 3.0 participants.
Measures.
Demographic questionnaire. Parents and adolescents provided information during their participation in Project CASL about their age, gender, place of birth, years in the United States, educational level, and parental household income.
Adolescent-reported parent psychological control. Regarding perception of parental practices, adolescents reported degree of parental psychological control using an adapted 11-item, Likert-scale version of Barber’s (1996) Parental Control Scale (PCS). On this measure, adolescents reported their perceptions of their mother’s and father’s level of psychological control over them. This version of the PCS includes items for evaluating parental attitudes that reflect disappointment, guilt, and pride across four parental control subsets: personal attack, erratic emotional behavior, guilt induction, and love withdrawal. Cronbach's alphas for the maternal psychological control and paternal psychological control in this sample were .82 and .92, respectively.
Adolescent-reported Asian values adherence. Adolescent values were assessed using the Asian Values Scale (AVS; Kim, Atkins, & Yang, 1999). The AVS measures each rater’s level of adherence to Asian cultural values using a 7-point Likert scale. Choices range from 1 = strongly
disagree to 7 = strongly disagree, with 18 out of 36 total items reverse scored prior to analyses. The total score provides a method for determining adherence to Asian values with six factors of Asian cultural dimensions: conformity to norms, family recognition through achievement, emotional self-control, collectivism, humility, and filial piety. Kim, Atkins, & Yang (1999) also determined that the AVS was both internally consistent, with coefficient alphas of .81 and .82 in two different studies, and reliable over a 2-week period, with a coefficient alpha of .83.
Cronbach's alpha in this sample was .79.
Emerging adult-reported parent-child conflict. Conflict between parents and emerging adults will be measured using the Asian American Family Conflicts Scale (FCS; Lee, Choe, Kim, & Ngo, 2000). This ten-item emerging adult report scale was developed to assess the likelihood and seriousness of family situations, particularly related to values and practices between U.S.-raised children and their Asian immigrant parents. Respondents are asked to rate the likelihood that presented family situations, such as “Your parents tell you what to do you’re your life, but you want to make your own decisions,” will occur between themselves and their parents from 1 = almost never to 5 = almost always. The seriousness of such a situation is rated from 1 = not at all to 5 = extremely. Validation with Asian American university-students determined that the FCS demonstrates a mean score of 27.39 and a Cronbach’s alpha value of 0.89. Cronbach’s alpha for this measure in this sample was .87.
Emerging adult-reported help-seeking intentions. Intentions to seek help in emerging adult participants were measured using the General Help-Seeking Questionnaire (GHSQ;
Wilson, Deane, Ciarrochi, & Rickwood, 2005). The GHSQ was created to measure intentions to seek help from different sources based on problems. Specifically, this measure seeks to
problems and suicidal ideation. For each of ten potential sources for help, which includes sources of informal help-seeking, participants rated on a Likert scale whether or not they intend to seek help from that source from 1 = extremely unlikely to 7 = extremely likely. Validation studies by Wilson, Deane, Ciarrochi, and Rickwood (2006) determined a Cronbach’s alpha of 0.93 and three-week test-retest reliability of 0.88 for the suicidal problems scale and a Cronbach’s alpha of .70 and three-week test-retest reliability of .86 for the personal-emotional problems scale. Cronbach’s alpha for this sample was .48
Emerging adult-reported frequency of help-seeking behaviors. Help-seeking behaviors were measured by a researcher-developed checklist reflecting the ten potential sources of help found on the GHSQ. For each of the ten potential formal and informal sources of help,
participants rated on a Likert scale whether or not they have ever sought help from that source from 1 = never to 7 = daily. Cronbach’s alpha for this sample on this measure was .58.
Emerging adult-reported attitudes toward help-seeking behaviors. In order to measure attitudes toward seeking formal, professional sources of help, the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS; Mackenzie, Knox, Gekoski, & Macaulay, 2004) will be utilized. The IASMHS is a 24-item measure that assesses perceived behavioral control
regarding an individual’s mental health services seeking behaviors. Items are rated on a Likert scale from 0 = disagree to 4 = agree. Three factors, psychological openness, help-seeking propensity, and indifference to stigma, were identified to explain individuals’ help-seeking behaviors. Cronbach’s alpha for the IASMHS was 0.9, with Cronbach’s alphas of 0.82, 0.76, and 0.70 for the psychological openness, help-seeking propensity, and indifference to stigma factors, respectively. Cronbach’s alpha for this sample on this measure was .82.
Emerging adult-reported perception of social support. The Interpersonal Support Evaluation List-12 (ISEL-12; Cohen, Mermelstein, Kamarck, & Hoberman, 1985) is the short form version of the ISEL, which was originally designed to measure an individual’s perception of social support across three subscales: appraisal support, belonging support, and tangible support. The ISEL-12 contains 12 items, 6 of which are reverse coded, rated on a Likert scale from 1 = definitely false to 4 = definitely true. Cohen (2008) determined that the ISEL-12 demonstrates an overall Cronbach’s alpha of 0.86. Cronbach’s alpha for this sample on this measure was .78.
Emerging adult-reported internalizing problems. To examine emerging adult well-being and functioning, two subscales of the Behavior Assessment System for Children, Second
Edition—College Self-Report (BASC-2-SRP-College; Reynolds & Kamphaus, 2004) will be utilized. The BASC-2 Self-Report measures the behavioral and social emotional functioning of children and young adults between the ages 6 years and 25 years. Items are rated on a 4-point Likert scale and provide results within broad domains of functioning, including Internalizing Problems. The BASC-2-SRP-College combined gender coefficient alpha reliability is .96 for the Internalizing Problems composite while the test-retest reliability is .83.
Emerging-adult reported depressive and anxious symptoms. Another measure of emerging-adult well-being will be obtained using two modules from the Patient Health
Questionnaire (PHQ; Spitzer, Kroenke, Williams, & Patient Health Questionnaire Primary Care Study Group, 1999). The PHQ was developed as a self-administered version of the Primary Care Evaluation of Mental Disorders (MD; Spitzer et al., 1994). While the original PRIME-MD was developed and validated to efficiently identify five common types of mental health disorders in medical populations, the PHQ was developed as a self-report measure in which each
module acts as a screener for a single mental health concern and can be used alone or in conjunction with other modules. Two modules used to identify depressive and anxious
symptoms were used in this study. The PHQ-9 is a 9-item module within the PHQ designed to assess symptoms of depression often observed in outpatient populations. The PHQ-9 scores range from 0 to 27, with depressive symptom severity marked by minimal or none (total score 0-4), mild (total score 5-9), moderate (total score 10-10-4), moderately severe (total score 15-19) and severe (total score 20-27; Kroenke & Spitzer, 2002). In general, scores between 15 and 27 will likely warrant active treatment with psychotherapy or medication, or a combination of both. The GAD-7 is a 7-item module within the PHQ designed to assess symptoms of anxiety often
observed in outpatient populations. The GAD-7 scores range from 0 to 21, with anxious
symptom severity marked by minimal or none (total score 0-4), mild (total score 5-9), moderate (total score 10-14), and severe (total score 15-21; Spitzer, Kroenke, Williams, & Löwe, 2006). In general, scores greater than 15 will likely warrant active treatment. Both the PHQ-9 and GAD-7 ask respondents to rate items on a 4-point Likert scale with response selections of “not at all,” “several days,” “more than half the days,” and “nearly every day.” Kroenke, Spitzer, Williams, and Löwe (2010) determined that the PHQ-9 demonstrates an overall Cronbach’s alpha of between .86 and .89 and a test-retest reliability of .84. Cronbach’s alpha for this sample on the PHQ-9 was .87. Kroenke et al. (2010) also determined that the GAD-7 demonstrates an overall Cronbach’s alpha of .92 and a test-retest reliability of .83. Cronbach’s alpha for this sample on the GAD-7 was .86.
Emerging adult-reported satisfaction with life. In order to determine self-reported judgment with their own satisfaction with life, the Satisfaction with Life Scale (SLS; Diener, Emmons, Larsen, & Griffin, 1985) will also be administered. The SLS is a 5-item scale that
utilizes a 7-point Likert scale from 1 = strongly disagree to 7 = strongly disagree. The SLS has a coefficient alpha of .85 and a 2-week test-retest reliability of .84 (Pavot, Diener, Colvin, & Sandvik, 1991). Cronbach’s alpha for this sample was. 86.
Data analyses.
In order to test the hypothesized model, correlational analyses and path analyses will be conducted using SPSS and MPlus statistical software. All subsequent analyses will be informed by prior conducted analyses such that, descriptive and correlational analyses will be conducted first in order to determine relations amongst major study variables. If study variables are unrelated in correlational analyses, such relations will not be included or tested in the path model. Additionally, the literature has often examined help-seeking intentions separately from formal and informal help-seeking behaviors. If scores on formal and inform help-seeking behaviors are highly (significantly) correlated, the scores will be averaged to compute a composite for general help-seeking in final analyses; if they are not highly (significantly) correlated, the scores will be analyzed separately.
If results from correlational analyses suggest the proposed mediation pathways are
present (see Figure 1), those pathways will be tested using path analyses. The literature related to the impacts of parent-child conflict and well-being have been well-documented; however,
whether help-seeking may serve as a mediator or a moderator between parent child-conflict is unclear. Since it is unclear whether or not help-seeking behaviors function as a mediating or moderating effect in the literature, if a mediating effect is found between parent-child conflict, help-seeking behaviors, and well-being outcomes, the moderating effect will also be tested as hypothesized in Figures 2 and 3.
Figure 1: Hypothesized path model testing for mediation from culture and parenting to well-being outcomes
Figure 2: Hypothesized path model testing for moderation from culture and parenting to help-seeking behaviors and well-being outcomes
Figure 3: Hypothesized path model for moderation from culture and parenting to help-seeking intentions and well-being outcomes
CHAPTER IV RESULTS
Preliminary Analyses
Demographic characteristics, including age, gender, and country of birth for the 60 participants included in Project CASL 3.0 are shown in Table 1.
Table 1: Demographic characteristics of participants
Demographic characteristics of participants
Frequency Percent Age 19 1 1.70 20 7 11.70 21 13 21.70 22 15 25.00 23 10 16.70 24 9 15.00 25 3 5.00 26 2 3.30 Gender Male 24 40.00 Female 36 60.00 Birth Country United States 49 81.70 China or Taiwan 8 13.30 Other 3 5.00
Parent Birth Country
United States 3 5.00
China or Taiwan 53 88.30
Other 1 1.70
Missing 3 5.00
Descriptive data for all study variables, including means and standard deviations are shown in Table 2. Main study variables ranged from -.71 to 1.729 in skewness and -.77 to 3.03 in kurtosis and met criteria for multivariate normality (Muthén & Kaplan 1985; Curan, West, &
Finch, 1996). To evaluate for possible gender differences, a one-way MANOVA was conducted and determined that no statistically significant difference existed in the main study variables based on gender, F(14, 34) = 1.23, p < .30; Wilk’s Λ = .66, partial η2 = .34.
Given the large amount of attrition that occurred between Project CASL and Project CASL 3.0, independent t-tests were utilized to determine whether or not participants who participated in Project CASL 3.0 differed from those who did not on major demographic
variables. Results from independent t-tests showed no significant differences between those who participated in Project CASL 3.0 and those who did not based on gender and country of birth, but a statistically significant difference between the two groups were found for socioeconomic status. Results showed that those who participated in Project CASL 3.0 were more likely to be from families who reported higher socioeconomic status during Project CASL than those who did not participate, t(100) = 2.19, p = .03.
Table 2: Descriptive data for study variables
Descriptive data for study variables
Mean (SD) Minimum Maximum
Asian values 4.23 (.49) 2.97 5.19
Maternal Psychological Control 2.55 (.80) 1.17 4.67
Paternal Psychological Control 2.55 (1.17) 1.18 6.00
Parent-Child Conflict 2.30 (.80) 1.00 4.10 Help-seeking Intentions 36.08 (6.52) 24.00 58.00 Help-seeking Frequency 29.43 (7.12) 10.00 47.00 Help-seeking Attitudes 87.48 (11.77) 62.00 113.00 Psychological Openness 27.48 (4.67) 18.00 38.00 Help-seeking Propensity 29.95 (5.09) 14.00 39.00 Indifference to Stigma 30.05 (4.96) 19.00 40.00 Interpersonal Support 2.58 (.21) 2.08 3.17 Internalizing Problems 46.78 (6.80) 37.00 65.00 Life Satisfaction 5.37 (1.11) 2.40 7.00 Depressive Symptoms 4.12 (3.98) .00 16.00 Anxious Symptoms 2.92 (3.36) .00 13.00
Correlational Analyses
Bivariate correlations among main study variables are presented in Table 3. Statistically significant correlations were identified between maternal psychological control and parent-child conflict, help-seeking intentions and help-seeking attitudes, and help-seeking attitudes and well-being outcomes. All correlations were in the expected and positive direction, with the exception of the relationship between help-seeking attitudes and depressive symptoms, which was in the expected and negative direction. Examination of the bivariate correlations amongst main study variables and help-seeking attitudes factors (e.g., including psychological openness, help-seeking propensity, and indifference to stigma) further supported a positive relationship between help-seeking and well-being. Significant correlations will be further discussed during examination of study hypotheses.
Parental psychological control, adolescent adherence to Asian values, and parent-child conflict. The first hypothesis of this study sought to identify evidence that lower adherence to Asian values and higher reported parental psychological control will predict higher reported levels of parent-child conflict. Bivariate correlation analyses showed no significant relation between adolescent-reported adherence to Asian values and parent-child conflict; however, results do show that maternal psychological control is positively related to parent-child conflict (r = .30, p < .05), which would be consistent with the view that maternal psychological control predicts parent-child conflict.
Parent-child conflict and help-seeking intentions. The second hypothesis of this study sought to identify evidence that higher levels of parent-child conflict, in conjunction with lower reported adherence to Asian values and higher parental psychological control, will predict lower levels of help-seeking intentions. Given that no significant relation was found between adherence
to Asian values and parent-child conflict, only the relations between maternal psychological control, parent-child conflict, and help-seeking intentions were explored further. Bivariate correlations did not identify any significant relation between maternal psychological control and help-seeking intentions. Additionally, no significant relation was identified between parent-child conflict and help-seeking intentions.
Further bivariate correlation analyses were conducted to explore whether relations differed between parent-child conflict that may be related to more formal (e.g., mental health professional, phone helpline) or informal (e.g., family, friends) help-seeking behaviors. Results are presented in Table 4. Analyses determined that parent-child conflict was positively related to intention to seek help from a doctor or general practitioner (r = .30, p < .05).
Parent-child conflict and help-seeking behaviors. The third hypothesis of this study sought to identify evidence that higher levels of parent-child conflict, in conjunction with lower reported adherence to Asian values and higher parental psychological control, will be related to lower levels of formal help-seeking behaviors. Bivariate correlations did not identify any
significant relation between parent-child conflict and general help-seeking behaviors. Descriptive statistics related to frequency of help-seeking behaviors are presented in Table 5. Of note,
participants report seeking help more frequently from intimate partners and friends more often than from any other source.
Help-seeking behaviors and well-being. The fourth hypothesis of this study sought to identify evidence that lower levels of help-seeking behaviors will predict lower levels of well-being, as indicated by higher levels of internalizing problems and lower life satisfaction. Bivariate correlations resulted in a statistically significant relation, such that help-seeking
intentions were positively related to satisfaction with life (r = .39, p < .01) and negatively related to depressive symptoms (r = -.34, p < .05).
Bivariate correlation analyses exploring specific help-seeking behaviors and well-being outcomes are presented in Table 6. Analyses determined statistically significant relations between informal help-seeking behaviors and satisfaction with life in the positive direction and internalizing symptoms in the negative direction. Specifically, seeking help from friends was positively related to satisfaction with life (p = .31, p <.05) and negatively related with anxious symptoms (r = -.30, p < .05). Similarly, seeking help from one’s parents was positively related to satisfaction with life (p = .29, p <.05) and negatively related to internalizing problems (p = .29, p <.01). Finally, not seeking help from any source was negatively related with satisfaction with life (p = -.42, p <.01) and positively related to internalizing symptoms (p = .36, p <.01), particularly depression (p = .26, p <.05). Thus, the fourth hypothesis was supported by study results.
Path Analyses
Bivariate correlations were examined to determine whether support for examining the hypothesized model in which parent-child conflict served as a moderator between parent psychological control and help-seeking or Asian values and help-seeking existed. Given
insignificant bivariate correlations between parent-child conflict and help-seeking intentions and behaviors, results do not support the need for conducting path analysis at this time. Further examination of bivariate correlations of main study variables to determine whether help-seeking intentions and behaviors may function as a moderator between parent-child conflict and well-being were also found to be insignificant.
Table 3: Bivariate correlations between study variables
Bivariate correlations between study variables
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. Asian values --
2. Maternal psychological control .07 --
3. Paternal psychological control .15 .59** --
4. Parent-child conflict .16 .30* .13 -- 5. Help-seeking intentions .18 -.08 .01 .20 -- 6. Help-seeking frequency .06 -.09 .04 .09 .30* -- 7. Help-seeking attitudes -.05 -.07 .04 .05 .16 .03 -- 8. Help-seeking attitudes: Psychological openness -.22 -.15 .03 -.03 .07 -.03 .79** -- 9. seeking attitudes:
Help-seeking propensity .06 .02 .15 .11 .27* .06 .78** .39** -- 10. Help-seeking attitudes: Indifference to stigma .03 -.05 -.08 .04 .03 .04 .83** .54** .45** -- 11. Interpersonal support -.21 -.07 -.13 .18 -.02 .12 .06 .06 .00 .92 -- 12. Internalizing problems -.03 .12 .02 .19 -.08 .12 -.17 -.15 -.09 -.16 .21 -- 13. Life satisfaction -.14 -.08 .03 -.03 .11 .13 .39** .27* .40** .26* .15 -.47** -- 14. Depressive symptoms -.15 .98 -.12 .03 -.07 .10 -.34** -.29* -.20 -.33** -.01 .62** -.32* -- 15. Anxious symptoms -.03 -.08 -.01 .11 .05 .24 -.20 -.15 -.07 -.26* .05 .62** -.24 .76** -- Note: *p<.05, **p<.01
